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In many species with encapsulated larval development, the larvae play an active role in hatching. However, the factors that control when the larvae hatch from each egg-capsule within an egg-mass are largely unknown. Advanced egg-masses of the gastropod Crepipatella peruviana were used to determine the hatching time of capsules from each egg-mass. After each female was detached, the egg-mass was also removed from the substrate and all capsules were then counted and measured. All capsules were examined to determine the time of hatching and the order in which capsules hatched from each egg-mass. Larvae were collected from each hatched egg-capsule and the number, size and weight of larvae from each capsule were determined. After 50–60% of the capsules from each egg-mass had hatched, the same characteristics of the remaining unhatched larvae from sister capsules were documented. Larvae were found to have hatched when they reached a size of 354 ± 22 μm (n = 245). Larvae from capsules within the same egg-mass hatched over a period of up to 12-days. The order of hatching in capsules from the same egg-mass was determined by larval content: capsules with fewer larvae and smaller capsules with heavier larvae hatched first. The hatching from one capsule in any given egg-mass did not induce the hatching of its sister capsules. Furthermore, hatching also occurred successfully in the mother absence, suggesting that this process is largely or completely controlled by the encapsulated larvae, although a possible maternal role in synchronizing hatching cannot be excluded.
Mounting U.S. research suggests many non-White individuals feel solidarity with, and identify as, people of color (PoC). Yet measurement limitations prevent scholars from testing whether these constructs are empirically different. We explain why these concepts diverge and evaluate our claims with an expanded battery of measures across U.S. Asian, Black, Latino, and Multiracial adults (N = 3402). Using multi-group confirmatory factor analysis, we show these items capture related but distinct concepts among PoC (configural invariance). We then establish that these items uniformly measure each construct across PoC groups (metric invariance), with mean level differences validly reflecting actual heterogeneity between groups, rather than measurement artifacts (scalar invariance). Finally, consistent with our conceptualization, we show that solidarity among PoC mediates the association between PoC identification and support for policies that implicate various communities of color. We end with practical advice for using these items in surveys of racially diverse populations.
The field of healthcare epidemiology is increasingly focused on identifying, characterizing, and addressing social determinants of health (SDOH) to address inequities in healthcare quality. To identify evidence gaps, we examined recent systematic reviews examining the association of race, ethnicity, and SDOH with inpatient quality measures.
Methods:
We searched Medline via OVID for English language systematic reviews from 2010 to 2022 addressing race, ethnicity, or SDOH domains and inpatient quality measures in adults using specific topic questions. We imported all citations to Covidence (www.covidence.org, Veritas Health Innovation) and removed duplicates. Two blinded reviewers assessed all articles for inclusion in 2 phases: title/abstract, then full-text review. Discrepancies were resolved by a third reviewer.
Results:
Of 472 systematic reviews identified, 39 were included. Of these, 23 examined all-cause mortality; 6 examined 30-day readmission rates; 4 examined length of stay, 4 examined falls, 2 examined surgical site infections (SSIs) and one review examined risk of venous thromboembolism. The most evaluated SDOH measures were sex (n = 9), income and/or employment status (n = 9), age (n = 6), race and ethnicity (n = 6), and education (n = 5). No systematic reviews assessed medication use errors or healthcare-associated infections. We found very limited assessment of other SDOH measures such as economic stability, neighborhood, and health system access.
Conclusion:
A limited number of systematic reviews have examined the association of race, ethnicity and SDOH measures with inpatient quality measures, and existing reviews highlight wide variability in reporting. Future systematic evaluations of SDOH measures are needed to better understand the relationships with inpatient quality measures.
Women experiencing severe perinatal mental health problems require specialized services and care. Perinatal mental disorders are common and can contribute to maternal mortality, affecting neonatal, infant, and child outcomes. Home treatment can prevent hospital admissions and promote strategies within the patient’s support network.
Objectives
Our aim is to describe a clinical case in perinatal psychiatry managed by a Psychiatric Home Treatment Unit.
Methods
We present a case of perinatal psychotic depression in a 26-year-old pregnant woman.
Results
We describe the case of a patient with no prior history of mental health issues. She was 25 weeks pregnant when she first sought psychiatric help in July 2023 and was diagnosed with depressive disorder with psychotic symptoms. She reported symptoms such as low mood, psychomotor inhibition, delusional guilt thoughts, and auditory hallucinations beginning three weeks before her initial visit. Due to her clinical presentation, the patient was admitted to the hospital, where pharmacological treatment was initiated with Olanzapine 5 mg, Sertraline 50 mg, and Lorazepam 1.5 mg. She remained in the hospital for four days, during which she showed gradual improvement but did not achieve full recovery.
Considering the improvement observed, home treatment was proposed and accepted by the patient and her relatives. During home treatment, she continued to exhibit persistent depressive and psychotic symptoms, including low mood, inhibition, and delusional thoughts of ruin and catastrophe. Therefore, her treatment was adjusted, with Olanzapine increased to 10 mg, Sertraline raised to 100 mg, and Lorazepam reduced to 0.75 mg. Over time, significant improvement in her clinical symptoms was noted. Throughout the follow-up period, she reported no significant side effects from the pharmacological treatment. After a month of follow-up in our department, she was discharged with outpatient care provided by a specialized community perinatal psychiatric unit.
Conclusions
We illustrate the possibility of home treatment for perinatal psychiatric disorders. The potential benefits of remaining close to one’s support network and developing coping strategies can be advantageous during the course of illness. Further studies should be conducted to explore these potential benefits.
Psychotic patients are a vulnerable population from a social and health point of view. The SARS Cov-2 pandemic affected millions of people around the world, however, its effects on psychotic patients in Avilés Spain, have not been analized.
Objectives
The objective of this study was to determine and compare the mortality of patients with psychosis due to SARS Cov-2 in Avilés, Spain with others regions and countries in the European Union. Determine the influence of social condition and antipsychotic treatment on the condition of these patients.
Methods
This is a descriptive, observational study, in which patients diagnosed with psychosis in the period 2020-2021 who contracted SARS Cov-2 infection in Avilés, Spain, were studied to determine those who died from this cause. The influence of social status and antipsychotic medication, as well as sociodemographic factors (age, sex, marital status) were analyzed and compared with other regions and countries of the European Union.
Results
Despite the high mortality rate in patients with psychosis, during the years of the pandemic SARS Cov-2 played an important role given the vulnerability of these patients.
Conclusions
The negative effects and deaths during the COVID-19 pandemic were at the time a major problem for public health worldwide. This study concluded that the morbidity and mortality of psychotic patients who contracted COVID-19 was lower than the rest of the population.
Suicide is a global public health issue. According to the latest available data from the National Institute of Statistics, 4,003 people died by suicide in 2021, reaching a new historical high. Approximately 90% of suicide victims suffer from one or more severe psychiatric disorders, and there is a documented 20-fold higher risk of suicide in individuals with affective disorders compared to healthy subjects (Abdelnaim et al., 2020). Repetitive transcranial magnetic stimulation (rTMS) has been established as an effective alternative or complementary treatment option for patients with depressive disorders, but little is known about its effects on suicide risk.
Objectives
To assess the efficacy of rTMS in reducing depressive symptoms in patients with suicidal ideation and behaviors.
Methods
Population and Methods: A retrospective analysis was conducted on a sample of 28 psychiatric patients (23 females; mean age 49.36 ± 16.23) with suicidal ideation identified by item 3 (suicidality) of the Hamilton Depression Rating Scale (HDRS), who were treated with rTMS. All patients received a minimum of 30 sessions, consisting of the application of a high-frequency (>10Hz) or intermittent theta burst stimulation (TBS) over the left dorsolateral prefrontal cortex (DLPFC) at an intensity of 120% of the resting motor threshold (RMT), and repeated low-frequency pulses (1Hz) or continuous TBS over the right DLPFC with an intensity of 110% of the RMT.
Results
Results: The results show a statistically significant improvement in depressive symptoms following rTMS intervention (p < 0.001). Furthermore, remission was observed in 46% of the sample (HDRS < 8).
Conclusions
Discussion: In line with recent studies (Abdelnaim et al., 2020; Hines et al., 2022) and systematic reviews (Cui et al., 2022; Bozzay et al., 2020) on suicidal ideation in the context of psychiatric disorders, the findings of this study demonstrated that rTMS achieved satisfactory results in reducing depressive symptoms and suicidal ideation.
Conclusions: This clinical study indicates preliminary promise for the prevention of suicidal acts and underscores the need for more detailed and specific research on rTMS in the field of suicide.
As part of the intervention, patients with severe schizophrenia who are cared for in psychiatric rehabilitation units need psychological treatments. However, there is great variability within the psychotherapy alternatives that are proposed for rehabilitation in schizophrenia, and it is necessary to know which are the most efficient interventions in order to prioritize their inclusion in intervention programs.
Objectives
To know the level of evidence of the existing psychotherapy alternatives for the rehabilitation treatment in schizophrenia through the systematic review of recently published studies.
Methods
Consecutive systematic searches in the scientific literature were used in a sensitive and specific way, aimed at identifying the existence of documents in databases and clinical practice guidelines based on evidence of psychological treatment in schizophrenia. Psychosocial and social approaches and family members interventions were excluded, and the search was limited to the last 5 years. The PICO format has been used, and a subsequent critical reading using the AGREE II tool, considering the inclusion criteria of presenting a score >60% in 4 domains.
Results
The following interventions have been found to be therapeutically effective: Level 1B (Early intervention in Psychosis; Patient and Family psychoeducational intervention; Basic ando social skills training; Social cognition and Metakognition training; Cognitive Remediation; Cognitive Behavioral Individual Therapy; Assertive Community treatment; Supported employment). Level 2B (Family Problem Solving Therapy, Dynamic Psychotherapy; Cognitive Behavioral Group Therapy); Level 2C (Horticultural, Art, Music, Animals Therapies).
Conclusions
Several psychotherapy alternatives are proposed for rehabilitation in schizophrenia, with known level of evidenca in order to prioritize their inclusion in intervention programs.
Migration has been present in the evolution of human beings throughout history. Economic inequalities give rise to a permanent flow of people trying to improve their lives. In addition, there are people who are forced to seek asylum or refuge due to wars or political violence. Therefore, the migratory flow, gives rise to a clinical scenario in which, the arrival of immigrant people demands an adaptation of the psychiatric paradigm.
Objectives
The objective of this paper is to review the international scientific literature published on the impact of the migration process on mental health.
Methods
We propose a review of the international scientific literature published in recent years on psychiatry and migration.
We present the case of a 27-year-old male, diagnosed with paranoid schizophrenia, who arrived in the Canary Islands after a 2-year migration process from his country of origin (Senegal).
Results
The limits between normality and pathology of certain types of behavior vary from one culture to another.
In the case of a patient with a mental disorder who has undergone a migration process, an approach based on the cultural formulation of the case should be made, taking into account the process of adaptation to the culture of the host country, as well as the impact of the culture of origin on the patient’s interpretation of his or her psychopathology.
Conclusions
Culture can influence the acceptance or rejection of a diagnosis and treatment, affecting the course of the disease and recovery.
Therefore, understanding the cultural context in which the disease is experienced is essential for a good diagnostic evaluation and effective clinical management.
Disclosure of Interest
N. Molina Pérez: None Declared, J. Pereira López: None Declared, M. I. Santana Ortiz: None Declared, P. Rivero Rodríguez: None Declared, A. R. Del Rosario Grant / Research support from: Jansen Pharmaceuticals, Inc., Consultant of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc., Employee of: Universidad de Las Palmas de Gran Canaria, Speakers bureau of: Jansen Pharmaceuticals, Inc.; Lundbeck, Inc.; Otsuka Pharmaceutical Co.; Pfizer Inc.; Esteve Pharmaceuticals, S.A.; AstraZeneca Pharmaceuticals LP.; Angelini Pharma S.L.U.; Laboratorios Farmacéuticos ROVI SA., M. Grimal: None Declared, V. Acosta Pérez: None Declared
Numerous countries, notably within Europe, have sanctioned the practice of euthanasia. Extant legal frameworks meticulously define the extent, essence, and application of euthanasia, encompassing divergent characterizations, explications of entitlements, procedural modalities, and provisions for access. Nonetheless, the precise function of psychiatrists within these legislative contours remains conspicuously nebulous.
Objectives
The present inquiry undertakes a comprehensive evaluative review of the euthanasia phenomenon vis-à-vis the intricate tapestry of European legislative paradigms, with an emphasis on elucidating the multifaceted involvement of psychiatry within this evolving landscape.
Methods
A nuanced narrative review is undertaken, encapsulating the contemporary state-of-affairs, fundamental conceptual architectures, the tenets of the Spanish Organic Law 03/2021, and the pharmaceutic armamentarium deployed in the orchestration of euthanasic practices. Additionally, the methodological blueprint employed within a prominent tertiary healthcare institution situated in Madrid is meticulously expounded.
Results
To date, euthanasia has garnered legal imprimatur across diverse jurisdictions including, but not limited to, the Netherlands, Belgium, Colombia, Canada, Spain, and New Zealand. The ambit of assisted death and its application to the domain of mental infirmities is meticulously deconstructed. Within the overarching realm of foundational concepts, a rigorous delineation is rendered between euthanasia, medical succor in the throes of mortality, assisted self-termination, facilitated demise, provision of mortal release, judicious calibration of therapeutic enterprise, and the contours of palliative sedation. Distinction between the principal executor and the advisory consultant is rendered salient. The rubric of conscientious objection emerges as an inviolable entitlement of healthcare practitioners enmeshed in the provisionary matrix.
The enduring incumbency of the psychiatrist as a pivotal appraiser of cognitive and volitional faculties holds firm. The conspicuous influence of psychopathological constellations upon the contours of euthanasia eligibility precipitates cogent deliberation.
Conclusions
As the frontiers of euthanasia expand to encompass an augmented array of legal jurisdictions, this study underscores the increasingly intricate role inhabited by psychiatrists in the matrix of evaluative assessments. The proclivity of mental maladies to exert a substantial gravitational pull upon determinations of eligibility for euthanasia accentuates the exigency for refined explication of roles and responsibilities within this evolving sphere, a clarion call resonant not only within the precincts of psychiatry but reverberating across the broader firmament of medical praxis.
Artificial Intelligence (AI) is reshaping the world as we know it, impacting all aspects of modern society, basically due to the advances in computer power, data availability and AI algorithms. The dairy sector is also on the move, from the exponential growth in AI research, to ready to use AI-based products, this new evolution to Dairy 4.0 represents a potential ‘game-changer’ for the dairy sector, to confront challenges regarding sustainability, welfare, and profitability. This research reflection explores the possible impact of AI, discusses the main drivers in the field and describes its origins, challenges, and opportunities. Further, we present a multidimensional vision considering factors that are not commonly considered in dairy research, such as geopolitical aspects and legal regulations that can have an impact on the application of AI in the dairy sector. This is just the beginning of the third tide of AI, and a future is still ahead. For now, the current advances in AI at on-farm level seem limited and based on the revised data, we believe that AI can be a ‘game-changer’ only if it is integrated with other components of Dairy 4.0 (such as robotics) and is fully adopted by dairy farmers.
During an ecological study with a near-endangered anuran in Brazil, the Schmidt’s Spinythumb frog, Crossodactylus schmidti Gallardo, 1961, we were given a chance to analyze the gastrointestinal tract of a few individuals for parasites. In this paper, we describe a new species of an allocreadiid trematode of the genus Creptotrema Travassos, Artigas & Pereira, 1928, which possesses a unique trait among allocreadiids (i.e., a bivalve shell-like muscular structure at the opening of the ventral sucker); the new species represents the fourth species of allocreadiid trematode parasitizing amphibians. Besides, the new species is distinguished from other congeners by the combination of characters such as the body size, ventral sucker size, cirrus-sac size, and by having small eggs. DNA sequences through the 28S rDNA and COI mtDNA further corroborated the distinction of the new species. Phylogenetic analyses placed the newly generated sequences in a monophyletic clade together with all other sequenced species of Creptotrema. Genetic divergences between the new species and other Creptotrema spp. varied from 2.0 to 4.2% for 28S rDNA, and 15.1 to 16.8% for COI mtDNA, providing robust validation for the recognition of the new species. Even though allocreadiids are mainly parasites of freshwater fishes, our results confirm anurans as hosts of trematodes of this family. Additionally, we propose the reallocation of Auriculostoma ocloya Liquin, Gilardoni, Cremonte, Saravia, Cristóbal & Davies, 2022 to the genus Creptotrema. This study increases the known diversity of allocreadiids and contributes to our understanding of their evolutionary relationships, host–parasite relationships, and biogeographic history.
The ability to quickly refresh gas-jet targets without cycling the vacuum chamber makes them a promising candidate for laser-accelerated ion experiments at high repetition rate. Here we present results from the first high repetition rate ion acceleration experiment on the VEGA-3 PW-class laser at CLPU. A near-critical density gas-jet target was produced by forcing a 1000 bar H$_2$ and He gas mix through bespoke supersonic shock nozzles. Proton energies up to 2 MeV were measured in the laser forward direction and 2.2 MeV transversally. He$^{2+}$ ions up to 5.8 MeV were also measured in the transverse direction. To help maintain a consistent gas density profile over many shots, nozzles were designed to produce a high-density shock at distances larger than 1 mm from the nozzle exit. We outline a procedure for optimizing the laser–gas interaction by translating the nozzle along the laser axis and using different nozzle materials. Several tens of laser interactions were performed with the same nozzle which demonstrates the potential usefulness of gas-jet targets as high repetition rate particle source.
Due to decades of structural and institutional racism, minoritized individuals in the US are more likely to live in low socioeconomic neighborhoods, which may underlie the observed greater risk for neurocognitive impairment as they age. However, these relationships have not been examined among people aging with HIV. To investigate neurocognitive disparities among middle- and older-aged Latino and non-Latino White people living with HIV (PWH), and whether neighborhood socioeconomic deprivation may partially mediate these relationships.
Participants and Methods:
Participants were 372 adults ages 40-85 living in southern California, including 186 Latinos (94 PWH, 92 without HIV) and 186 non-Latino (NL) Whites (94 PWH, 92 without HIV) age-matched to the Latino group (for the overall cohort: Age M=57.0, SD=9.1, Education: M=12.7, SD=3.9, 38% female; for the group of PWH: 66% AIDS, 88% on antiretroviral therapy [ART]; 98% undetectable plasma RNA [among those on ART]). Participants completed psychiatric and neuromedical evaluations and neuropsychological tests of verbal fluency, learning and memory in person or remotely. Neuropsychological results were converted to demographically-unadjusted global scaled scores for our primary outcome. A neighborhood socioeconomic deprivation variable (SESDep) was generated for census tracts in San Diego County using American Community Survey 2013-2017 data. Principal components analysis was used to create one measure using nine variables comprising educational (% with high school diploma), occupational (% unemployed), economic (rent to income ratio, % in poverty, (% female-headed households with dependent children, % with no car, % on public assistance), and housing (% rented housing, % crowded rooms) factors. Census tract SESDep values were averaged for a 1km radius buffer around participants’ home addresses.
Results:
Univariable analyses (independent samples t-tests and Chi-square tests) indicated Latinos were more likely to be female and had fewer years of formal education than NL-Whites (ps<.05). Latino PWH had higher nadir CD4 than White PWH (p=.02). Separate multivariable regression models in the overall sample, controlling for demographics and HIV status, showed Latinos had significantly lower global scaled scores than Whites (b=-0.59; 95%CI-1.13, -0.06; p=.03) and lived in more deprived neighborhoods (b=0.62; 95%CI=0.36, 0.88; p<.001). More SES deprivation was significant associated with worse global neurocognition in an unadjusted linear regression (b=-0.55; 95%CI=-0.82, -0.28; p<.001), but similar analyses controlling for demographics and HIV status, showed SESDep was not significantly related to global scaled scores (b=-0.11; 95%CI= -0.36, 0.14; p=.40). Exploratory analyses examined primary language (i.e., English vs Spanish) as a marker of Hispanic heterogeneity and its association with neurocognition and SESDep. Controlling for demographics and HIV status, both English-speaking (b=0.33; 95%CI=0.01. 0.64; p=.04) and Spanish-speaking Latinos (b=0.88; 95%CI=0.58, 1.18; p<.001) lived in significantly greater SESDep neighborhoods than Whites, with SESDep greater for Spanish-speakers than English-speakers (p<.001). However, only English-speaking Latinos had significantly lower neurocognition than Whites (b=-0.91; 95%CI=0-1.57, -0.26; p<.01; Spanish-speakers: b=-0.27; 95%CI=-0.93, 0.38; p=.41).
Conclusions:
Among our sample of diverse older adults living with and without HIV, English-speaking Latinos showed worse neurocognition than Whites. Though SES neighborhood deprivation was worse among Latinos (particularly Spanish-speakers) it was not associated with neurocognitive scores after adjusting for demographics. Further studies investigating other neighborhood characteristics and more nuanced markers of Hispanic heterogeneity (e.g., acculturation) are warranted to understand factors underlying aging and HIV-related neurocognitive disparities among diverse older adults.
Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.
Psychotic disorders carry several economical, psychological and social consequences, both at individual and community levels. Early intervention programs after first-episode psychosis which combine pharmacological and psychosocial strategies are aimed at reducing symptoms, lowering costs in the use of health and non-health care resources and improving overall functioning. AGES-Mind study is based on manualized psychotherapeutic interventions for people with first-psychosis episodes.
Objectives
The aim of the study was to evaluate the effect of a group psychotherapeutic intervention on the clinical status and use of clinical resources in a sample of patients with first-episode psychosis at 12 and 24 months after the beginning of the intervention. This cohort will be compared to patients with first-psychosis episodes without group psychotherapeutic intervention.
Methods
Longitudinal, observational, retrospective study on a cohort of N=46 patients with first-episode psychosis within the last 5 years. Two groups of 23 patients each were formed. The participants of one of those groups received group psychotherapy in the context of the AGES-Mind study and the other group received treatment as usual without group intervention. Non-exposed patients were matched by age, gender and time elapsed since first-episode psychosis with those exposed to the intervention. Sociodemographic data, clinical status and use of clinical resources outcome variables were assessed.
Results
No significant differences were found in clinical status and use of resources between participants and non-participants in the psychotherapeutic group intervention after 12 and 24 months.
Conclusions
After controlling for potentially confounding variables as sociodemographic, age and time since first-episode, participating in a group psychotherapeutic program does not seem to improve clinical variables or use of resources. Further studies with larger samples would be necessary to explore other variables, such as symptoms, satisfaction with the intervention or social functioning.
Early intervention on a first psychotic episode is fundamental for a more favorable prognosis, and it usually combines pharmacological treatment, which mainly affects positive psychotic symptoms, with interventions that can improve the rest of the symptoms and associated problems such as deterioration in social functioning (Harvey & Penn, 2010; Fusar-Poli, McGorry & Kane, 2017). While Mindfulness is gaining more and more prominence in the field of psychotherapy (Chan et al., 2019; Cillesen et al., 2019), social cognition and social functioning are being researched as key targets on which to intervene after a first psychotic episode (Green, Horan & Lee, 2015).
SocialMIND® is a mindfulness-based social cognition training tailor-made to improve social functioning in people who have suffered a first psychotic episode within the last five years. It is currently being compared with a group Psychoeducational Multicomponent Intervention (PMI) in a Randomized Controlled Trial (RCT) (Mediavilla et al., 2019). Both group psychotherapies include 17 sessions delivered over a 9 month period: 8 weekly sessions, 4 biweekly sessions and 5 monthly sessions.
The results of SocialMIND® at 8 weeks showed improvements in social cognition and social functioning, specifically on affective social cognition and self-care (Mediavilla et al., 2021).
Objectives
To evaluate the efficacy of SocialMIND® in improving social functioning, measured by the Personal and Social Functioning (PSP) scale 16 weeks after starting the intervention, in people who have suffered a first psychotic episode in the last 5 years.
Methods
Randomized, controlled pilot trial (use of a psychoeducational multicomponent intervention or PMI as active comparator) of two parallel groups (SocialMIND® and PMI) with a 1:1 ratio using a blind evaluator.
Results
No statistically significant differences were found in the social functioning variable between the two treatment arms. Intragroup differences are observed in other secondary variables studied (social cognition) 16 weeks after starting the interventions.
Conclusions
SocialMIND® has not been shown to be more effective than a PMI in improving social functioning at 16 weeks after starting the intervention in people who have suffered a first psychotic episode in the five years prior to being included in the study.
Resistant schizophrenia is a schizophrenia subtype characterized by a non-ability to respond to an appropriate antipsychotic treatment in dosage and duration by the patients. These patients show a lower prognostic and symptomatology. The unique drug which has shown efficacy for resistant schizophrenia treatment is clozapine, which is effective in suicide and aggressive behaviour prevention too. Whereas clozapine has numerous and serious adverse effects such as agranulocytosis risk. Because of this, and for guaranteeing an accurate diagnosis of resistant schizophrenia, distinguishing this from pseudo-resistance due to a poor tracing of schizophrenia, clozapine’s plasmatic levels monitoring is recommended in Spain by many clinical practise-guidelines.
Objectives
This studio has the objective of determining if altered clozapine’s plasmatic levels have predictive potential of therapeutical response and answering what clinical and sociodemographic variables are associated to these anormal plasmatic levels.
Methods
In this work, a cross-sectional observational study was carried out in which clinical and sociodemographic data obtained by the Mental Health Unit of the Jerez de la Frontera University Hospital were collected within the research project entitled: "Role of social cognition as a factor psychosocial functioning of the schizophrenic patient” (ECOFUN), of all the participating patients (in total the sample was 141 patients, of which 40 are in treatment with clozapine).
Results
The sample of patients has a mean age of 44 years and medium-high educational levels. The vast majority are men and do not currently consume substances of abuse, and when this consumption occurs, tobacco and alcohol are the most consumed substances. Their total scores on the PANSS and Markova Barrios scales are generally very disparate, but with average values of 55 and 16. It has been obtained as results that there is no significant statistical correlation between the plasma levels of clozapine and the values of the PANSS scale and its subscales in the patients. On the other hand, patients treated with clozapine would present clinical and sociodemographic characteristics practically identical to those of patients treated with other antipsychotics, especially their values on the PANSS scale. In addition, plasma levels of clozapine are correlated, although not significantly, with an improvement in the positive symptomatology of schizophrenia.
Conclusions
As a conclusion, unusually higher values of clozapine are correlated significantly with lower values in positive symptomatology in schizophrenia, but plasmatic levels are not correlated significantly with values of PANSS scale.
Home Treatment (HT) teams are among the better-studied options to reduce admission at the hospital, having been described as an alternative to hospitalization in patients with schizophrenia. There may be certain risk factors which has already been described such as living alone (Dean and Gadd, BMJ, 1990; 301, 1021–1023; Schnyder et al., Acta Psychiatr. Scand. 1999; 99, 179–187), lack of awareness of the illness, uncooperativeness (Cotton et al., BMC Psychiatry, 2007; 7, 52) and fewer visits carried out (Morgan et al., Aust. New Zeal. J. Psychiatry,2006; 40, 683–690) which together can negatively influence the possibility of conducting intensive home follow-up and, therefore, increase the likelihood of hospitalization.
Objectives
To describe de relative contribution of several risk factors to patient hospitalization related to the possibility of conducting intensive home follow-up of patients diagnosed with Schizophrenia following home treatment. Second, to determine de risk of hospitalization related to the possibility of conducting intensive home follow-up according to the presence of one or more risk factors of patients diagnosed with Schizophrenia following home treatment.
Methods
All patients with schizophrenia who were visited by a home treatment team in Barcelona between January 2017 and December 2021 were included in the study. To assess whether there was an increased risk of hospitalization associated with factors such as living alone, uncooperativeness (PANSS G8 item >= 4) and ≤1 home visit, two bivariate logistic regression analyses were conducted. We studied these factors as independent variables to assess the relative contribution to the risk of hospitalization, and we studied if the presence of 1, 2, 3 or 4 of these risk factors as independent variables worsened the risk of hospitalization.
Results
Uncooperativeness shows the highest contribution to the risk of hospitalization, followed by ≤ 1 home visit, lack of insight and living alone, all results reaching significance (p=0.000).
There is an increase in the risk of hospitalization depending of the presence of 1,2,3 or 4 of these risk factors (1 risk factor (Odds Ratio = 1.21), 2 risk factors (Odds Ratio = 5.28), 3 risk factors (Odds ratio = 13.53), 4 risk factors (Odds ratio = 29.18).
Conclusions
There are a number of factors directly related to the possibility of conducting intensive follow-up that appear relevant in the case of psychotic patients in acute crisis treated at home. This set of variables are the lack of awareness of the illness, lack of collaboration, living alone and the number of visits that have been made, all with statistically significant differences in our study. These factors together also greatly increase the risk of hospitalization, becoming almost 30 times more likely when these 4 factors are present.
Central nervous system (CNS) tumours are the most common type of solid tumour in the paediatric population. Although advances in treatment have improved survival rates, there is a substantial body of literature documenting the potential long-term effects such as psychological, neurocognitive and health-related sequelae experienced by survivors of paediatric brain tumours. TMS is a non-invasive brain stimulation technique that uses electrical stimuli applied to the cranial surface to restore neuronal connections damaged because of CNS disruption (Burke et. al., 2019).
Objectives
To test the efficacy of TMS in a patient diagnosed with a CNS tumour who reported pain and suffered severe cognitive-behavioural alterations refractory to other pharmacological treatments.
Methods
Case Presentation. A 12-year-old boy diagnosed with a hypothalamic-pituitary tumour at the age of 9, having received surgical treatment, radiotherapy and chemotherapy. He suffered loss of vision, cognitive-behavioural and emotional sequelae, and pain, for which he received various pharmacological treatments without benefit. Treatment. The patient underwent a total of 25 sessions where each session took 20 minutes to complete for 3 sessions per week. TMS intervention consisted of 1200 inhibitory magnetic pulses with a frequency of 1hz on right DLPFC at an intensity of 110% of resting motor threshold. Stimulations were carried out using a Magventure MagPro X100 equipment with a double-cone coil. The clinical assessment included The Silhouettes Fatigue Scale (PHQ-9), Pain Catastrophizing Scale (PCS) and Numerical Rating Scale (NRS), verbal subtests of the Weschler Intelligence Scale for Children (WISC-V), Patient Health Questionnaire (PHQ-9) and the Sleep Disturbance Scale for Children, SDSC
Results
In the post-treatment clinical interview with the family, qualitative changes included a decrease in subjective complaints of pain and fatigue. The family reported that the child stopped sleeping tied up after the intervention and a significant change in slowness was observed, which was accompanied by a higher level of awareness and consequently a slight improvement at the behavioural level, which at the present time does allow for psychological intervention. The psychometric results were clinically improved for psychomotor activity, sleep, emotional alterations, and all cognitive domains.
Conclusions
25 sessions of TMS in the right DLPFC could show beneficial effects on pain, fatigue, cognition, health and sleep variables in patients with drug-resistant sequelae derived from CNS tumours. Longitudinal studies with larger sample sizes are needed to determine whether the effects observed after TMS intervention in paediatric patients with CNS diseases are significant.